| NPI | 1861759110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENT A TIDWELL President 205-561-2195 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NR0400X Chiropractor, Rehabilitation (Licence: AL 2100) |
| Enumeration Date | 2012-04-11 |
| Last Update Date | 2022-07-21 |